Benefits and Programs

In 2000 many countries were concerned about the long-term stability of the various social protection programs. Public debate, reform proposals, and actual reforms were guided by this concern. The pros and cons of the involvement of private elements in public social protection schemes were discussed, and governments and social security administrators continued their efforts to modernize schemes. New approaches, including new technology, were used to improve welfare delivery and to promote fairness and opportunity.

North America

Election-year pressures in 2000 generally dictated social protection activity in the United States. Though a torrent of proposals and much debate occurred, lawmakers postponed passing most new legislation in the partisan-divided Congress.

Two of the strongest threads in the social safety net—Social Security and Medicare—were among the top issues of the presidential campaign; candidates pushed ideas that reflected their respective parties’ views of public versus private responsibility. Both Medicare and Social Security received good news early in the year when new projections indicated that they were in better financial shape than had been thought. Trustees of the Medicare Hospital Insurance Trust Fund estimated that Medicare would be solvent until 2023, eight years longer than they reported previously. It was the longest solvency projection for Medicare since 1975. Social Security trustees extended the solvency projection from 2034 to 2037; even if no action was taken, Social Security would be able to pay all promised benefits until 2037 and 72% of promised benefits after that date. Behind the revised projections were the continued strong economy and, in the case of Medicare, government efforts to contain costs and eliminate waste and fraud. Despite the improved outlook, both programs continued to face problems, especially as 76 million baby boomers headed into retirement over the next few decades, with increased life expectancy and soaring health care costs. Social Security, for example, would begin paying out more in benefits than it received from payroll taxes in 2015, and Medicare was expected to reach that tipping point in 2010.

The better-than-expected outlook did not halt all efforts in Congress to make changes in the programs. The most significant new legislation was a repeal of the earnings limit for Social Security recipients over age 65. By an overwhelming vote, Congress ended the practice of deferring Social Security benefits for people aged 65 through 69 who continued to work and earned more than a defined threshold of income each year.

Aside from this, however, most action took place on the presidential campaign trail. Texas Gov. George W. Bush, the Republican nominee, proposed a major shift in Social Security from a program of government-guaranteed benefits to one in which private markets and investment risks would be involved. The Bush plan would allow young workers to divert some of their payroll taxes into private savings accounts through which they could invest in stocks and bonds.

Democratic nominee Vice Pres. Al Gore supported a less-radical change in which the federal government would match contributions from eligible individuals with tax credits that varied according to a person’s income. Gore proposed to use excess payroll tax revenue—an estimated $2.4 trillion over 10 years—to pay down the national debt, arguing that this would bolster the economy and make it easier to meet future Social Security needs. A number of bipartisan groups also recommended moving toward private accounts, but most plans guaranteed a minimum benefit to make sure that recipients did not fall into poverty. Still others suggested dealing with the looming threat to Social Security’s solvency by raising the retirement age and/or payroll taxes or by lowering benefits. The retirement age was already slated to rise from 65 to 67 in slow incremental stages.

When it came to Medicare, both major party candidates offered plans to deal with a widely recognized shortcoming in the program—the lack of coverage for prescription drugs, which was the fastest-growing form of health care costs in the United States. Almost one-third of Medicare recipients had no drug coverage; the other two-thirds bought private insurance or received drug coverage through Medicaid (the federal-state health care program for the poor) or “medigap” plans that supplemented Medicare.

As with Social Security, the Republican plan would involve the private sector, creating a system in which private insurance companies competed with the government to provide coverage for beneficiaries. The elderly could use government subsidies to purchase government-approved private insurance, including drug coverage, or stay in Medicare. The plan proposed by the Democrats earmarked $253 billion over 10 years to add prescription drug benefits to Medicare.

Another continuing health care issue was how to help those who had no health insurance. The U.S. Census Bureau reported that after rising for 11 years, the number of people who lacked health insurance fell from 16.3% of the population in 1998 to 15.5% in 1999, primarily as a result of government programs such as Medicaid and the State Children’s Health Insurance Program (SCHIP) for youngsters whose families could not afford private insurance but made too much money to qualify for Medicaid. That left, however, an estimated 42.6 million Americans, including about 10 million children, without insurance. A report released by the Institute of Medicine, part of the National Research Council, warned that health care assistance for the poor provided through sources such as local clinics, public hospitals, and charitable organizations was overburdened and underfunded and could collapse without an infusion of more money and attention. Gore proposed spending $146 billion over 10 years to expand SCHIP. Bush’s solution was to use $75 billion over the same period for tax credits to help people buy private insurance. Congress considered some legislation dealing with the uninsured, but most of it did not pass.

As welfare reform marked its fourth anniversary, the Department of Health and Human Services reported that the rolls continued to shrink—to 2.4 million families at the end of 1999, compared with 2.7 million at the start of that year; the number had stood at 4.6 million when the overhaul was enacted in 1996. The report revealed that for the third straight year every state had met standards required by law for the proportion of welfare recipients who were working or preparing for a job. Independent studies found that those left on the rolls increasingly were minorities and children who did not live with their parents.

With Congress slow to move in the social welfare field, Pres. Bill Clinton took some actions on his own. To combat the tight housing market in big cities, he announced that the federal government would increase the value of subsidies given to low-income renters under the “Section 8” housing program, one of the government’s largest housing programs, serving three million households. The Department of Housing and Urban Development reported that a record 5.4 million low-income renters paid more than half their incomes for rent or lived in “seriously distressed” housing.

Clinton also announced help for community and faith-based organizations to expand facilities where teenage mothers could receive support. The government reported that teen birthrates were down in 1999 for the eighth straight year—dropping to 49.6 births per 1,000 women aged 15 to 19, the lowest level in the 60 years the data had been kept.

There was other encouraging news about the segment of the population at whom most social programs were aimed. A Census Bureau report in September noted a decline in the percentage of Americans living in poverty. According to the report, 2.2 million households moved above the poverty level (defined as $17,029 for a family of four) in 1999, and the proportion of those living in poverty fell from 12.7% in 1998 to 11.8% in 1999—the lowest point in more than two decades. Seven states and the District of Columbia registered declines in poverty population, while none had a statistically significant rise. A separate study by the National Center for Children in Poverty, a nonpartisan research centre at Columbia University, New York City, found that the child poverty rate fell significantly in a few states. It also revealed, however, that in most states and in the country as a whole, child poverty was higher in 1998—the last year for which figures were available—than in 1979.

In Canada too the main concern was the country’s strained health care system. After nearly a year of wrangling about financing and reforming health care, federal and provincial ministers agreed on a plan in September. Under the compromise, the federal government would restore more than Can$5 billion (Can$1.48=$1) a year in contributions to health and social programs by 2005, bringing its transfers to $21 billion annually. In addition, Ottawa would provide Can$1 billion for medical equipment and Can$800 million for health care reform. Federal transfer payments to the provinces had been cut in 1995 in an effort to eliminate the deficit, and this caused the Canada Health and Social Transfer block fund to fall to Can$11 billion in 1996. The debate over what to do included a push by Health Minister Allan Rock for a new home-care program that would relieve hospitals. In the end, the ministers settled for a plan that gave provinces more money to keep the existing system going and did not change federal and state jurisdictions. For their part, provinces gave up demands for automatic yearly increases tied to economic factors. In another area Canada’s employment insurance rules were altered to extend parental leave from 10 to 35 weeks. The benefits were available to either the mother or the father.

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